The children also had a high frequency of microdontia, teeth smaller than normal (44% as opposed to 2% of the Finnish population). Microdontia was common among children under five years of age at stem cell transplantation and rare among others. Surprisingly, high-dose anticancer chemotherapy caused microdontia in all those who had been treated when under three years old. Total body irradiation did not increase the number of microdontia patients or microdontic teeth.
Developmental aberrations in dental roots were found in all the children in the study. Some of them had minor changes visible in a few teeth only, while others had severe damage in all their teeth. Total body irradiation increased the number of damaged roots. The children who had only received high-dose anticancer chemotherapy had root damage in over half of their teeth, but the damage was not as severe as with those who had also received total body irradiation.
The lack of several permanent teeth and their small size affect the development of occlusion and the growth of the jaws. Short and sometimes almost non-existent roots may not endure masticatory forces, and periodontal infections may result in an early loss of short-rooted teeth. "We still don't know about the long-term consequences of the treatments, which is why the monitoring of the patients should be continuous and centralised. Cooperation between specialists in children's haematology and oncology and specialists in various fields of dentistry is of fundamental importance in providing for these children the best possible dental care in the future," Pivi Hltt says.
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Contact: Pivi Hltt
paivi.holtta@helsinki.fi
358-40-560-9711
University of Helsinki
29-Aug-2005